CPT 43405 Surgery - Digestive

How Much Does Ligate/staple esophagus Cost?

Ligate/staple esophagus (CPT 43405) costs $1,402 at Medicare rates.

Medicare (Facility)
$1,402
CMS PFS 2026 national rate

Procedures Commonly Done Together

These procedures are frequently performed alongside Ligate/staple esophagus

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How to Reduce Your Cost for Ligate/staple esophagus

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

24.11
Work RVU
11.80
Practice Expense RVU
6.07
Malpractice RVU
41.98
Total RVU

Payment = Total RVU (41.98) x CF ($33.40) = $1,402

Frequently Asked Questions

How much does Ligate/staple esophagus cost?

The Medicare facility rate for Ligate/staple esophagus is $1,402. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Ligate/staple esophagus cost without insurance?

Without insurance, the cost of Ligate/staple esophagus can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Ligate/staple esophagus?

Most commercial health insurance plans and Medicare cover Ligate/staple esophagus when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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